Self-Esteem in Children and Adolescents After Septic Shock Caused by Neisseria meningitidis: Scars Do Matter

Vermunt, Lindy C.; Buysse, Corinne M.; Joosten, Koen F.; Oranje, Arnold P.; Hazelzet, Jan A.; Verhulst, Frank C.; Utens, Elisabeth M.

doi:10.1016/j.jadohealth.2007.09.026

« Previous Next »Journal of Adolescent Health
Volume 42, Issue 4 , Pages 386-393, April 2008

Self-Esteem in Children and Adolescents After Septic Shock Caused by Neisseria meningitidis: Scars Do Matter

Lindy C. Vermunt, M.Sc.
- Department of Child and Adolescent Psychiatry, Erasmus Medical Centre, Rotterdam, The Netherlands
- Department of Pediatrics, Subdivision of Pediatric Intensive Care, Erasmus Medical Centre, Rotterdam, The Netherlands
Corinne M. Buysse, M.D.
- Department of Pediatrics, Subdivision of Pediatric Intensive Care, Erasmus Medical Centre, Rotterdam, The Netherlands
Koen F. Joosten, M.D., Ph.D.
- Department of Pediatrics, Subdivision of Pediatric Intensive Care, Erasmus Medical Centre, Rotterdam, The Netherlands
Arnold P. Oranje, M.D., Ph.D.
- Department of Dermatology and Venereology, Erasmus Medical Centre, Rotterdam, The Netherlands
Jan A. Hazelzet, M.D., Ph.D.
- Department of Pediatrics, Subdivision of Pediatric Intensive Care, Erasmus Medical Centre, Rotterdam, The Netherlands
Frank C. Verhulst, M.D., Ph.D.
- Department of Child and Adolescent Psychiatry, Erasmus Medical Centre, Rotterdam, The Netherlands
Elisabeth M. Utens, Ph.D.
- Department of Child and Adolescent Psychiatry, Erasmus Medical Centre, Rotterdam, The Netherlands
- Address correspondence to: Elisabeth Utens, Ph.D., Erasmus MC–Sophia Children’s Hospital, Department of Child and Adolescent Psychiatry, P.O. Box 2060, 3000 CB Rotterdam, The Netherlands.

Received 11 April 2007; accepted 4 September 2007. published online 13 February 2008.

Abstract

Purpose

To investigate self-esteem and its relation to scars, amputations, and orthopedic sequelae in children and adolescents long term after meningococcal septic shock (MSS) caused by Neisseria meningitidis.

Methods

The Dutch versions of the Self-Perception Profile for Children (SPP-C; 8–11 years) and the Self-Perception Profile for Adolescents (SPP-A; 12–17 years) were used to assess self-esteem. The Patient and Scar Assessment Scale (PSAS) was used to evaluate scar severity.

Results

MSS boys aged 8–11 years achieved higher, more favorable scores on self-esteem, whereas same-aged MSS girls reported comparable levels of self-esteem compared with the respectively same-aged reference boys and girls. MSS boys and girls aged 12–17 years obtained unfavorable scores on self-esteem compared with respectively same-aged reference boys and girls. Overall gender did not have an effect on self-esteem. Severity of illness, age at time of illness, and age at time of follow-up were not significant predictors of self-esteem. MSS adolescents with scars reported lower global self-worth than MSS adolescents without scars. The worse MSS children evaluated their scars, the worse their outcomes on social acceptance. The worse MSS adolescents evaluated their scars, the worse their outcomes on close friendship, but the better their outcomes on social acceptance and behavioral conduct.

Conclusion

In this cross-sectional study, favorable outcomes for self-esteem were found in MSS children, whereas MSS adolescents reported lower self-esteem compared with reference adolescents. Adolescents with scars reported lower global self-worth than MSS adolescents without scars.

Keywords: Septic shock, Neisseria meningitidis, Self-esteem, Children and adolescents, Scars, Amputations